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Provider Quick Alert

February 1, 2021
Review all Medical Coverage Policies at QualChoice.com.
New and Amended Medical Policies

P = Payment Change
C = Code Change
V = Verbiage Change

Medical Policy Number
 Medical Policy Name Effective Date of Change Description of Changes
BI062  V
Preventive Health Benefit01/01/21Colorectal cancer screening is covered under the preventive benefit starting at
age 45.
BI336  V
Benlysta02/01/21Updated to include coverage for active lupus nephritis.
Coming Amendments

Medical Policy Number
 Medical Policy Name Effective Date of Change Description of Changes
BI063  V, C
Non-Face-to-Face Services03/01/21Covered non-face-to-face services to promote behavioral health integration: Inter-Professional Services (99446-99449 and 99451, 99452); Behavioral Health Care coordination (99484); Psychiatric Collaborative Care management (99492, 99493 and 99494). No pre-authorization required. Medical records may be requested to ensure CMS documentation requirements are being met.
Spinal Surgery03/01/21Injection to peripheral nerve branch (CPT 64450) is covered without pre-authorization.
For questions about QualChoice Medical Coverage Policies, please contact your Provider Relations Representative at 800.235.7111 or 501.228.7111, ext. 7004, Monday through Friday, 8:00 a.m. to 5:00 p.m.
2102 MK 002